St John’s Wort: OCD Cure or Hoax?

Background

St. John’s wort (hypericum perforatum) was originally used to treat mild to moderate depression, and it quickly became popular. More than a million Americans were already taking it by the late 1990s. Eventually, scientists began to test the herb to see whether it could help control the symptoms of some other disorders such as OCD. Although the jury is still out about the efficacy of St. John’s wort, OCD sufferers hope that it will one day prove to be an effective alternative to the drugs commonly prescribed.

Conflicting Studies

Some studies have shown vast improvements in subjects taking St. John’s wort, such as a study in the Journal of Clinical Psychology, which found that subjects scored much higher on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) after treatment with St. John’s wort. Other studies have failed to show this effect. For example, in 2005 a study published in International Clinical Psychopharmacology showed no significant differences between subjects taking St. John’s wort and a control group taking a placebo. There is therefore insufficient research to show whether St. John’s wort is truly effective in treating OCD, or whether it merely has a placebo effect.

How Does It Work?

Although it’s not known exactly how St. John’s wort works against Obsessive Compulsive Disorder, it seems to selectively inhibit the synaptosomal reuptake of serotonin. People with OCD tend to have more serotonin than other people do, and St. Johns wort essentially stops the body from using it as effectively. This is very similar to the way that SSRIs (selective serotonin reuptake inhibitors) work. SSRIs are the primary drugs used to treat OCD.

Interestingly, St. Johns wort does inhibit the uptake of other brain chemicals as well, such as dopamine and norepinephrine, just as effectively as it does for serotonin. Most SSRIs purely inhibit the reuptake of serotonin. Clomipramine, however, is one SSRI that blocks other brain chemicals besides serotonin. It is also currently believed to be the best SSRI to use against OCD. One theory is that St. John’s worth is especially effective because it blocks some of these other brain chemicals, just like clomipramine.

Possible Problems

There are several possible problems that you should be aware of before taking St. John’s wort. OCD sufferers should take into account that there is no real government checking on herbal supplements before marketing, so a bottle of St. John’s wort could have different amounts or different content in each batch. It is also dangerous to take too much of St. John’s wort orally, although this is true about many medicines, both natural and synthetic.

St. John’s wort can also cause severe reactions to sunlight, so wear sunblock when you are out in the sun for long periods, and cover up as much skin as possible with brimmed hats, long sleeve shirts, and long pants. St. John’s wort can interact with many drugs, so speak to a practitioner about any other medicines you are taking before trying St. John’s wort. Women should not take it during breastfeeding or while pregnant, as there is insufficient research on whether it is safe.